Provider First Line Business Practice Location Address:
90 WEST CHESTNUT ST
Provider Second Line Business Practice Location Address:
SUITE 125LL
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-3422
Provider Business Practice Location Address Fax Number:
724-222-8391
Provider Enumeration Date:
06/23/2006